U.S. citizens sometimes skip travel insurance for Puerto Rico on the assumption it’s “domestic,” which creates a real coverage gap. But here’s some information to understand why it’s worth buying anyway.

Hurricane season is real

June–November carries genuine storm risk (see Best Time to Visit). A named-storm cancellation without insurance usually means losing every non-refundable dollar you spent – flights, hotels, tours.

Health coverage gaps

Many mainland U.S. health insurance plans, including some Medicare Advantage plans, do not treat Puerto Rico as automatically in-network the way a U.S. state would – confirm your specific plan’s territorial coverage before you go.

Medical evacuation

Vieques and Culebra have only small local clinics – a serious injury there may require an emergency transfer to the main island, which travel insurance with medical evacuation coverage can cover.

Adventure activity coverage

Surfing, diving, hiking remote trails, and river tubing are covered by some policies and excluded by others – check the activity list before booking a west-coast surf trip or a Mona Island expedition.

Grid and infrastructure instability

Power and water outages (see Renewable Energy) can disrupt flights, refrigeration, and hotel operations even outside of storm season – trip-interruption coverage protects against these disruptions too.

What to look for in a policy

Prioritize: named-storm/hurricane cancellation coverage (ideally “cancel for any reason” if traveling June–November), medical coverage that explicitly includes Puerto Rico and medical evacuation, adventure-sport riders if your itinerary includes surfing, diving, or remote hiking, and trip-interruption coverage that accounts for airport or power disruptions.

This is general guidance, not a recommendation of a specific insurer or policy. Compare named-storm cancellation terms carefully – many basic policies exclude storms that were already named or forecast at the time of purchase.